MIF-TLIF治疗腰椎退行性疾病的疗效观察及对血清炎性因子的影响

Effect of MIF-TLIF in the treatment of lumbar degenerative disease and its influence on serum levels of inflammatory cytokines

目的探讨微创经椎间孔腰椎腰椎椎体融合术(MIF-TLIF)治疗腰椎退行疾病的临床效果及对患者血清炎性细胞因子的影响。方法选取2015-01-2016-02在我院手术治疗的100例腰椎退行疾病患者,根据患者手术方法分为MIF组(MIF-TLIF治疗)46例、传统组(传统开放TLIF手术)54例,对比两组患者的术后效果及血清白细胞介素-6(IL-6)、IL-10、肿瘤坏死因子-ɑ(TNF-ɑ)、肌酸激酶(CK)。结果 MIF组的手术切口长度、出血量、术后引流量、住院时间、术后3天VAS评分均显著的低于传统组(P<0.05);术后24 h,MIF组的血清IL-6、IL-10、TNF-ɑ、CK水平均显著的低于传统组(P<0.05);术后1个月、3个月,MIF组的ODI指数低于传统组(P<0.05),术后6个月、1年,两组患者的ODI指数差异无统计学意义(P>0.05)。结论 MIF-TLIF治疗腰椎退行疾病手术效果可靠、创伤小、恢复快、对术后患者的炎症反应指标影响小。

Objective To investigate the clinical effect of minimally invasive transforaminal lumbar interbody fusion(MIF-TLIF)in the treatment of lumbar degenerative disease,and its influence on serum inflammatory cytokines.Methods From January 2015 to February 2016,100 cases with lumbar degenerative disease were selected in our hospital.According to different operation methods,the patients were divided into MIF group(MIF-TLIF treatment,46 cases)and the traditional group(traditional open surgery TLIF,54 cases).The postoperative effect and serum levels of interleukin 6(IL-6),IL-10,tumor necrosis factor alpha(TNF-alpha),creatine kinase(CK)were compared between two groups.Results The incision length,bleeding volume,postoperative drainage,hospitalization time,VAS score of postoperative 3 days in MIF group were significantly lower than those in the traditional group(P<0.05).24 h after operation,the serum levels of IL-6,IL-10,TNF-alpha,CK in MIF group were significantly lower than those in the traditional group(P<0.05).At 1 month and 3 months after operation,the ODI index of MIF group was lower than that in the traditional group(P<0.05),6 months and 1 year after operation,there was no significant difference in ODI index between the two groups(P>0.05).Conclusion MIF-TLIF is effective in the treatment of lumbar degenerative disease.It has the advantages of reliable operation,less trauma,faster recovery,and less influence on postoperative inflammatory response.